Painful, itchy skin linked to obesity in kids

NEW YORK (Reuters Health) - Small children who are obese may be more likely to develop severe eczema, a painful, extremely itchy skin condition, a new study says.

Compared to children who weren't obese, kids who became obese between the ages of 2 and 5 years old had more than three times the risk of developing the condition. If they were even younger when they became obese - babies or toddlers - their risk of the uncomfortable skin disease seemed to be even higher.

To make matters worse, when the skin condition occurred in the obese kids, it was more severe than usual.

"The more severe (cases) tend to be in agony," said Dr. Jonathan Silverberg, a dermatologist at St. Luke's-Roosevelt Hospital in New York.

"It impairs their sleep, it impairs their performance in school," Silverberg, who co-authored the study, told Reuters Health.

About one in ten kids in the general population has eczema, a chronic inflammation characterized by dry skin, intense itchiness, and discomfort, according to the American Academy of Dermatology.

According to the CDC, around one in ten kids under the age of five is obese.

"Children who are obese for a long time are more likely to get eczema," Silverberg said. "If you're able to reverse the obesity with weight loss, children may be less likely to develop eczema, or eczema symptoms may improve."

Using information from medical records, Silverberg and his colleagues studied more than 400 children and adolescents with eczema and about twice that number who didn't have the skin condition. Ages in the study ranged from 1 to 21 years.

Overall, the researchers found that obesity was nearly twice as common in children and adolescents with eczema. About nine of every 100 study participants with eczema were obese, compared to only five out of 100 without the skin disease.

And the researchers saw more cases of eczema among those who were obese at younger ages. For instance, for every 10 kids who were obese between the ages of 2 and 5, about six went on to develop eczema. By comparison, for every 10 kids who became obese some time after their fifth birthday, three eventually developed eczema.

Eczema is usually treated with creams or topical antibiotics. However, when it covers large areas of the body, doctors sometimes prescribe oral steroids, Silverberg said. Steroids could interfere with the children's growth, or affect their bone development.

Scratching also can often lead to infection, and it's "not uncommon to have to put children on oral antibiotics, sometimes multiple courses," Silverberg said.

Frequent use of antibiotics brings up another worry: people treated with lots of antibiotics are more vulnerable to superbugs like methicillin-resistant Staphylococcus aureus (MRSA). These antibiotic-resistant germs can live on the skin, and severe infections can sometimes become life-threatening, according to the Centers for Disease Control.

"The problem is that there is no cure" for eczema, Silverberg said. But by making sure that kids don't become obese, some of the risk of the skin condition might be avoided, he said.

This study does not show that being obese causes eczema, said Giamila Fantuzzi, associate professor of kinesiology and nutrition at the University of Illinois at Chicago. Instead, obesity and eczema may have a common cause.

"There is definitely a link between being obese and having inflammation, and (eczema) is an inflammatory disease," Fantuzzi, who was not part of the study, told Reuters Health.

"When people become obese, their fat tissue becomes larger, and it leads to the development of inflammation in fat tissue," she said. "This spills over into the rest of the body."

Weight loss would reduce this inflammation, and probably lead to a reduction in the skin disease as well, Fantuzzi said. Weight loss also reduces the risk of other obesity-related problems, like diabetes and heart disease.

"An appropriate diet, and having the kids move is the best thing," she said.